Vasculitis

Question 1

what is vasculitis

Answer 1

inflammation of blood vessels

Question 2

vessels changes that occur in vasculitis

Answer 2

vessel wall thickening vessel wall stenosis occlusion of vessels – infarction

Question 3

what are the two types of large vessel vasculitis

Answer 3

1. Giant cell arteritis 2. Takayasu arteritis

Question 4

what age group does giant cell arteritis present in

Answer 4

females > 50 years old

Question 5

what condition do 50% of people with giant cell arteritis also have

Answer 5

polymyalgia reumatica

Question 6

Giant cell arteritis affects which vessels

Answer 6

cranial branches of arteries from aortic arch

Question 7

symptoms of giant cell arteritis

Answer 7

unilateral throbbing headache scalp tenderness jaw claudication blurred vision systemic: fever, malaise

Question 8

what is a transient painless loss of vision in giant cell arteritis called

Answer 8

amaurosis fugax

Question 9

what is seen on biopsy in giant cell arteritis

Answer 9

multinucleated giant cells - can have skip lesions

Question 10

treatment of giant cell arteritis

Answer 10

prednisolone 40mg - 60mg if ocular involvement

Question 11

what age group does takayasu’s arteritis present in

Answer 11

females <40 more common in asians

Question 12

duplex ultrasound of temporal artery in GCA shows what?

Answer 12

halo sign

Question 13

signs of takayasu’s arteritis

Answer 13

unequal BP in arms bruits aortic regurgitation limi claudication hypertension

Question 14

treatment of takayasu’s arteritis

Answer 14

prednisolone 40-60mg

Question 15

what is henoch schonlein purpura

Answer 15

IgA vasculitis - commonly affects children

Question 16

presentation of henoch schonlein purpura

Answer 16

pupura - buttocks/lower limbs joint pain abdominal pain renal involvement - IgA nephritis

Question 17

treatment of henoch schonlein purpura

Answer 17

supportive

Question 18

what is polyarteritis nodosa

Answer 18

medium vessel arteritis associated with Hepatitis B

Question 19

how it takayasu’s arteritis diagnosed

Answer 19

CT / MRI angiography

Question 20

general symptoms of small vessel vasculitis

Answer 20

pupura - non blanching rash

arthritis

renal impairment

GI disturbance

neuropathy

Question 21

p-ANCA is associated with which types of vasculitis

Answer 21

eosinophilic granulomatosis with polyangitis (EGPA)

• Peviously known as Churg Strauss

microscopic polyangitis

Question 22

what are p-ANCA antibodies also known as

Answer 22

MPO

Question 23

Features of EGPA

Answer 23

Late onset asthma, rhinitis

raised eosinophil count

Question 24

differences between EGPA and microscopic polyangitis

Answer 24

both p-ANCA +ve

• absence of eosinophilia + granulomas in microscopic polyangitis
• sparing of upper airways in microscopic polyangitis
• glomerulonephritis in 90% of microscopic polyangitis, less common EGPA

Question 25

c-ANCA is associated with which type of vasculitis

Answer 25

Granulomatosis with polyangitis (GPA)

• previously knoen as Wegners syndrome

Question 26

features of GPA

Answer 26

Nose bleeds, recurrent sinusitis, deafness, nasal crusting

SOB + cough - cavitating opacities on CXR

Question 27

treatment of small vessel vasculitis

Answer 27

IV steroids + cyclophosphamide

Question 28

what is kawasaki disease

Answer 28

medium vessel vasculitis that affects young children, typically under 5

Question 29

features of kawasaki disease

Answer 29

• fever >5 days
• blanching rash
• conjunctivitis
• strawberry tongue (red tongue)
• red palms/soles than peel

Question 30

serious complication of kawasaki disease

Answer 30

coronary aneurysms

Question 31

treament of kawasaki disease

Answer 31

high dose aspirin + IV immunoglobulins

Question 32

what is Behcets

Answer 32

systemic vasculitis

• presents with arthritis, genital ulceration + eye inflammation
• young men, typically mediterranean/asian